Individual provider Active NPI

Sean Scott Rundle, D.C.

  • Chiropractor
  • Laguna Hills, CA
National Provider Identifier
1326129537
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC25269 Issued in CA
Practice address
25401 Cabot Rd
Suite 112
Laguna Hills, CA 92653-5524
Phone
(949) 588-7011
Fax
(949) 588-7012
NPI assigned
Oct 17, 2006
Last updated
Sep 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC25269 CA Primary

Addresses

Primary practice location

25401 Cabot Rd
Suite 112
Laguna Hills, CA 92653-5524

Mailing address

25401 Cabot Rd
Suite 112
Laguna Hills, CA 92653-5524
Phone (949) 588-7011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130314000395 CA Practitioner - Chiropractic 3274778519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

25401 Cabot Rd
Suite 112
Laguna Hills, CA 92653-5513
Phone (949) 588-7011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC25269CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Chiropractic, a Rundle Corporation Chiropractor CurrentSince Sep 4, 2002 Accepting new patients

Locations

25401 Cabot Rd
Ste 112
Laguna Hills, CA 92653
Phone (949) 388-1432

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1326129537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25401 CABOT RD",
            "address_2": "SUITE 112",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535524",
            "telephone_number": "949-588-7011",
            "fax_number": "949-588-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25401 CABOT RD",
            "address_2": "SUITE 112",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926535524",
            "telephone_number": "949-588-7011",
            "fax_number": "949-588-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDLE",
        "first_name": "SEAN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC25269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.